Describe the three ways that teens’ increased reward drive is manifested

User Generated

wrffvpn92

Humanities

Description

  • Describe the three ways that teens’ increased reward drive is manifested.
    • How might these be expressed in unhealthy ways that might present in therapy?
    • Discuss systemic intervention options that could potentially address these behaviors or concerns in ways that are consistent with Siegel’s discussion of brain changes and maturation.
  • Describe the similarities and differences of attachment functions and behaviors in adolescence compared to earlier life phases.
    • How does your growing knowledge of attachment as a lifelong need change how you view the therapeutic goals for adolescents?

Choose either scenario A or B and complete the following:

Scenario A

  • How would you respond to a parent who asks for advice about how to help her adolescent daughter stop being so emotional? Support your response with systemic and developmental justifications.

Scenario B

  • How would you respond to a 16-year-old male who tells you in an individual session that he and his girlfriend are planning to become sexually active?
    • Would you tell his parents? Why or why not?
    • How would your own experiences and values influence your interaction with this client?
    • What are the ethical limitations that must be considered when determining how much of your own value system is shared with the client and/or his parents?

Submit your assignment as a 6 page Microsoft Word document.


grading scale

The paper includes a response to a parent who asks for advice about how to help her adolescent daughter stop being so emotional that is supported with systemic and developmental justifications.

1.0 pts

This criterion is linked to a Learning OutcomeThe paper describes the three ways that teens’ increased reward drive is manifested and how they might be expressed in unhealthy ways that might present in therapy and discusses systemic intervention options that could potentially address these behaviors or concerns in ways that are consistent with Siegel’s discussion of brain changes and maturation.

1.0 pts

This criterion is linked to a Learning OutcomeThe paper describes the similarities and differences of attachment functions and behaviors in adolescence compared to earlier life phases and explains how growing personal knowledge of attachment as a lifelong need changes views the therapeutic goals for adolescents.

1.0 pts

This criterion is linked to a Learning OutcomeThe paper includes a response to a 16-year-old male who indicates he and his girlfriend are planning to become sexually active, including an explanation of whether to tell his parents, an evaluation of personal experiences and values and their influence on interaction with this client, and a consideration of the relevant ethical limitations.

1.0 pts

This criterion is linked to a Learning OutcomeThe paper is 3–5 pages in length, is formatted based on APA guidelines, and includes in-text citations and a reference page.

1.0 pts

This criterion is linked to a Learning OutcomeThe paper meets basic writing standards, including grammar, usage, spelling, punctuation, and organization.

1.0 pts

i missed a few assignments i need a a high A on this paper please,




this weeks reading which may help with the paper.

Vernacchio, A. (Sep 26, 2014). http://ideas.ted.com/what-teens-really-want-to-kno...

Trenholm, C., Devaney, B., Fortson, K., Clark, M, Quay, L., & Wheeler, J. (2008). Impacts of abstinence education on teen sexual activity, risk of pregnancy, and risk of sexually transmitted diseases

The Healthy Sex Talk: Teaching Kids Consent, Ages 1-21 (Links to an external site.)

"Dan Siegel - Brainstorm: The Power and Purpose of the Teenage Brain (Family Action Network)" (Links to an external site.)Links to an external site.

Unformatted Attachment Preview

Impacts of Abstinence Education on Teen Sexual X ,. ., n• I £ r\ Activity, Risk of Pregnancy, and Risk of Sexually ChHstopher Trenholm Barbara Devamy Kenneth Fortson Melissa dark Lisa Quay BHdgespan Transmitted Diseases ^ Z Abstract This paper examines the impacts of four abstinence-only education programs on adolescent sexual activity and risks of pregnancy and sexually transm^itted diseases (STDs). Based on an experimental design, the impact analysis uses survey data collected in 2005 and early 2006 from more than 2,000 teens who had been randomly assigned to either a program group that was eligible to participate in one of the four programs or a control group that was not. The findings show no significant impact on teen sexual activity, no differences in rates of unprotected sex, and some impacts on knowledge of STDs and perceived effectiveness of condoms and birth control pills. © 2008 by the Association for Public Policy Analysis and Management. INTRODUaiON Over the past decade, abstinence education programs have gained increasing support as an approach for reducing adolescent sexual activity and promoting healthy behavior among teens. Authorized under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, the Title V, Section 510 Abstinence Education Program was one of the legislative centerpieces that increased both the funding and visibility of abstinence education programs. Since fiscal year 1998, the Title V, Section 510 Abstinence Education Program has allocated $50 million annually for programs that teach abstinence from sexual activity outside of marriage as the expected standard for school-age children. Under a matching block grant program, states must match this federal funding at 75 percent, resulting in a total of up to $87.5 million annually for Title V, Section 510 abstinence education programs. All programs receiving abstinence education funding must comply with the "A-H" definition of abstinence education outlined in Figure 1. This definition requires programs to teach that abstinence is the only certain way to avoid pregnancy and sexually transmitted diseases (STDs); A-H abstinence education programs cannot provide instruction in or promote the use of contraception. In 1998, Congress authorized a rigorous evaluation of Title V, Section 510 abstinence education programs. The resulting multiyear evaluation included a rigorous, experimentally based impact evaluation designed to estimate the effects of abstinence education programs on teen sexual abstinence and related outcomes. Four programs were included in the impact evaluation: (1) My Choice, My Future! in Powhatan, Virginia; (2) ReCapturing the Vision in Miami, Florida; (3) Families United to Prevent Teen Pregnancy (FUPTP) in Milwaukee, Wisconsin; and (4) Teens in Control in Clarksdale, Mississippi. Journal of Policy Analysis and Management, Vol. 27, No. 2, 255-276 (2008) © 2008 by the Association for Public Policy Analysis and Management .""p- ®W1LEY Published by Wiley Periodicals, Inc. Published online in Wiley InterScience V , ) i t (www.interscience.wiley.com) ""^^ DOI: 10.1002/pam.20324 •y-i Impacts of Absthieiice Education on Scxualh Transitntfcd Di.sease.s A, l i a v e a s n s e x c l i i s i \ c purp{ adolescents. Their e o n e e r n witb c o n i p r e h e n s i \ e sex Jnnnuu'oj l\i!isi have examinetl ciiecis on potential m e d i a t o r s ol beha\ior, sueh as attiUides lowarei ieen sex o r irilenlions to abstain, ralhei" ihan on behavi(jral o u t c o m e s ibemseives. For- example, at a recent abstiiienee edtication evaltialion conterence, severed studies reported signilicant etlecls |iics tlit eclK relateii to ahstiiieTice (ii S'i'D risks. An adtiitioiia! health class in ytli f!i"ade cn\ 1,'red ahs( inence bni ditl not i'o\i.'r SI I)s or contracepi iw nse Jimrmd ManLlated sctiool (.mi icnlLun lor 6th thri>ui!h 8tli mm()n to most abstinence education programs. F.ach progtam conipiied with ihe "A-H" gtiidelincs, and iheii curricula shared a similat hnus and had many specific topic areas in conmtoti. A common perception is ihat abstinence educalion programs locus narrowly on teachirjg youth the single message olabslaining Ironi sexual acli\ity beloie mariiage. Restilts from ati irnplenienlanon atuil\sis stiggesl lliis is not (he ease. F-or e.\aniple, in addition to a locus ot) abslinence. aiS lotn- programs taughl youth abont ph\sical development and i'eproduction, promoled risk awareness, taught goal setling and giiod decisioti making, pro\it!ed insttiiction about healthy relationships, and soiight (o help vouth de\elop inleipersoual and ri^k-avoiclance skills. STUDY DESIGN AND METHODS Somple Inroke Sample intake took place near tiie begitming of three school \ears 1999 2000, 20(K) 2001, and 2OOU2OO2, In each of ihese veat-s, either progiatii or school staff identified those vouth who uere eligible lo participate in the programs. Once ideniilied, eligible students were given a stuclv consent loi-m iha! noiilied parenls ol iheir children's ehgibility for ihe program, e.Nplained the progratn anti the evaluation, and deseribed how selection lor the progratn would lake place through a lottery {t-andom assignment). .Acn\e parental eonsenl was oblained lor eaeh student enrolled in the e\a!uaiionOnce consent was obtained. sttttieiUs were randomly assigned to either ihe program or coiUt-ol group. In two of tfie lottr studs siies, the programs were noneieclixe school-basetl programs, and \ i r l u a l l \ all sfndcEUs returned consent forms and uere randomlv assignetl. The tesnits in the.se tuo siles- -My Choiee, M\ I'ttlttrei and 'feens in Control—therefore yenerali/e to all students of sinnlar age in ihose two sehool districts. In the other t u o sites, the pt-ogiatiss were electiw, meainng ihat eligible voulh could choose uhether to apply lor the program and, if ratulomlv assigned to the program group, could also decide whether to participate. In lhe.se two .siles, ihe results generalize lo all students who applied lor ihe abstinence ediicahori progr^uii. The lina! impact anal\sis sample includes 2,O,S7 youlh; just less ihan fiO petveiu (1,209) were assigned to the prrigrani group, and the remainder-(848) were assigned lo Uie control gt-oup ("(able 2). The sample sizes range from 414 voulh lor rUpi'P io 7 1 .S lor Teens in Control. Data uete collected Irotn the studx sample ihrough a series of loui- snrvevs. The^e included a baseline surves. admitiislered near the time that \ottlh began par(icipating in the study, and three foilow-ttp sur-\evs. The surAe\s uere administered either in school tising a peti-and-paper instrumen! or b\ phone, and all intervie\veis wetv independetit data collectors no! associated with either the program or' school district. The impact lindings are based on data collected Irom the final lollou-up suiAe\, which uas administered to studs \oiah betueen spring 2005 and uititer 2006. This reliects a loi!ou-up period ol rough!v 42 !o 78 months alter youlh began pariicipaling in the sltitly dependitig on the vear in uhich llie\ begati partieipatitig and ihe e^aet timing ol the siitAey. The lespotise r-ale on this sui\ev ranged Irom 80 fo 84 percent across the lour sitidy sites, leading lo an 82 percenl response rate (aerall. .hiunuil ( d> d d d d d d (^ O t^ vO vO O\ [--. ^H o (N O; OS ro '^ —; o -H •^ in 00 p -^ Tl; d d d d d o ^ -^ ro p in ^ so o IT) o oq o o O O O O O 2 a 00 ON vq p q p ^ p --^ o O CJ O O O 1 2 3^ bb o Q bD C 'C ta c o 3 rt rt -a o -C -C rt c oo K l2 o 00 .0 * CO r~ < * Journal of Policy Analysis and Management DOI: 10.1002/pam Published on behalf of the Association for Public Policy Analysis and Management Impacts of Abstinence Education on Sexually Transmitted Diseases I 265 number of sexual partners, expectations to abstain, and reported rates of pregnancy, births, and STDs. Knowledge ond Perceptions of Risks Associated with Teen Sexual Activity Measures of knowledge include the ability of youth to identify STDs, their understanding of potential risks of unprotected sex, and their knowledge of potential health consequences of STDs. Perceptions of risk include youth perceptions of the effectiveness of condoms and birth control pills for pregnancy prevention and for the prevention of several types of STDs, including human immunodeficiency virus (HIV), chlamydia and gonorrhea, and herpes and human papillomavirus (HPV). Analytic Methods Although random assignment ensures that program and control group youth are similar on average, regression models can improve statistical precision and control for chance differences between the two groups. For each outcome measure, program impacts were estimated using weighted regression models that pooled data from all f^our sites: 4 Yis = X ("'^ •S« + Ps Pis + Xisjs) + eis (1) where Yis is an outcome variable for student i in site 5 Sis is an indicator equal to 1 if student i is in site 5; 0 otherwise Pis is an indicator equal to 1 if student i is in the program group in site s; 0 otherwise Xis is a vector of baseline characteristics for student i in site 5 as, j8s, and ys are site-specific coefficients to be estimated Bis is a random error term The estimate of coefficient j8s provides the site-specific impact estimate. Regressionadjusted mean outcomes for program group youth in a given site were computed as the predicted value of the outcome variable for a student in that site who was in the program group but otherwise had the average characteristics of the students in that site; regression-adjusted means for control group youth were computed analogously. The difference between the regression-adjusted means for program and control group youth in a given site is equal to the impact estimate in that site. The pooled impact estimate was obtained simply by averaging the estimated impacts for each of the four individual sites. Specifically, the overall impact is the average of the estimated impacts of each program: 4 IMPACT = ^ /3s/4 (2) 5=1 where /§s is the estimated impact in site 5 from equation (1). This approach was preferred to weighting each site according to the size of its sample. Because the relative sample sizes of the sites in the evaluation were not representative of any broader populations, weighting each site according to the size of its sample would have arbitrarily given some sites more importance when computing a pooled Journal of Policy Analysis and Management DOI: 10.1002/pam Published on behalf of the Association for Public Policy Analysis and Management 266 / Impacts of Abstinence Education on Sexually Transmitted Diseases estimate. In contrast, the approach used here generates a more policy-relevant parameter: the impact observed for an average site in the evaluation, recognizing that each site represents a distinct approach to abstinence-only education. Although this approach was preferred, results are similar for a pooled estimation model that weights site-level impact estimates according to sample size. The weights used in the regression models accounted for the vadabilify in the probabilify of selection to the program or control groups as well as for youth who did not respond to the final follow-up survey. Selection weights were calculated as the inverse probability of selection to the group of assignment. Nonresponse weights were calculated using standard modeling techniques to estimate the probability of survey nonresponse as a function of baseline covariates. Standard errors from the models were calculated taking into account the variability associated with these weights. The regression models included a large number of variables (Xis) to control for individual demographic and background characteristics measured from the baseline survey (Table 4). For the small fraction of the sample who did not complete a baseline survey (fewer than 5 percent), a supplemental survey was administered at the next survey to collect key demographic information such as age, gender, and race/ethnicity. For other covariates, missing data on continuous measures were imputed using the mean for the remainder of the sample in a given program site, and missing data on categorical variables were either grouped with the omitted (base) category if item nonresponse was low or split into a separate missing category if item nonresponse was nonnegligible. In the two elective programs, a sizeable proportion of youth assigned to the program group did not participate in any program classes or other services, either because they chose to participate in other activities or they confronted scheduling conflicts or other participation barriers. (Nonparticipation among program group youth was 35 percent in ReCapturing the Vision and 43 percent in FUPTP.) Nonparticipation reflects the reality of many abstinence (and other) programs that serve youth on an elective basis, making it an important program feature to include in this study. Nonparticipation does not bias study findings for these sites. It does, however, reduce the statistical power of the study samples in these two sites, making it unlikely that a true program impact of modest size in either site (say, four or five points on a proportional outcome) would be found statistically significant. To account for nonparticipation among program group members, impact estimates were derived in two ways. The first was for the full program group, reflecting the average impact of having the opportunity to participate in the program among Table 4. Control variables used in the impact analysis. Demographics and Background Characteristics Site Enrollment cohort Date of interview Responded to previous surveys Gender Age Race/ethnicity Presence of mother figure Presence of father figure Parents married Baseline Contextual Factors Communication with parents Unmarried sister got pregnant Sibling dropped out of school Religiosity Expectations to have sex Baseline Measures of Behaviors and Potential Mediators of Teen Sex Had sex Perceived consequences of sex Views on abstinence Ability to resist pressure for sex Knowledge of STDs Journal of Policy Analysis and Management DOI: 10.1002/pam Published on behalf of the Association for Public Policy Analysis and Management Impacts of Abstinence Education on Sexually Transmitted Diseases I 267 those who applied, whether or not the youth actually chose to participate. These are the impact estimates presented in this paper. The second is only for those youth in the program group who actually participated, derived by using the Bloom correction of dividing the full-sample impact estimate by the participation rate (Bloom, 1984). Because the standard errors and significance levels associated with the participant-only estimates were roughly similar to those for the full program group, impact estimates that were not statistically significant for the full program group were not statistically significant for the participants either. As a result, the conclusions do not differ substantively when based on one set of measures or the other. RESULTS Impacts on Abstinence and Sexual Behavior None of the programs had statistically significant impacts on the rate of sexual abstinence, whether measured as either always remaining abstinent or being abstinent during the last 12 months (Table 5). Overall, about half of youth in both the control group and program group reported remaining sexually abstinent, and a slightly higher proportion reported abstaining from sex during the 12 months prior to the survey—55 percent of control group youth versus 56 percent of program group youth. This small difference was not statistically significant. Across the four sites, differences between the program and control groups were modest (5 percentage points or less) and not consistent in direction. On both measures, ReCapturing the Vision displayed the largest positive difference between the groups, but neither difference was statistically significant. Program and control group youth also did not differ in the number of partners with whom they had sex (Figure 2). About one-quarter of all youth in both groups had sex with three or more partners and about one in six had sex with four or more Table 5. Estimated impacts on abstinencefromsexual intercourse, overall and by site. 49 56 49 55 0 1 0.91 0.76 38 45 38 44 1 1 0.90 0.79 44 48 40 43 0.32 0.28 60 65 62 67 -3 —2 0.61 0.71 53 66 57 68 -4 -2 0.34 0.64 Ul Four Programs Combined Remained abstinent (always) Abstinent last 12 months My Choice, My Future! Remained abstinent (always) Abstinent last 12 months ReCapturing the Vision Remained abstinent (always) Abstinent last 12 months FUPTP Remained abstinent (always) Abstinent last 12 months Teens in Control Remained abstinent (always) Abstinent last 12 months Ul Program-Control Program Group Control Group Difference (Percentage) (Percentage) (Percentage Points) p-value Source: Wave 4 Survey of Teen Activities and Attitudes (Mathematica Policy Research, 2005), administered to youth 42 to 78 months after enrolling in the Title V, Section 5tO Abstinence Education Program study sample. Note: All estimates are based on weighted regression models. Joumal of Policy Analysis and Management DOI: 10.1002/pam Published on behalf of the Association for Public Policy Analysis and Management 268 / Impacts of Abstinence Education on Sexually Transmitted Diseases 75% - 50% " 49% 49% 25% - 16% 16% • o%Remained abstinent One partner 11% 11% , Two 1= partners 1 I Program 17% 16% 8% 8% Three partners 'A .' *>" Four or more partners • Control Figure 2. Estimated impacts on reported number of sexual partners. Source: Wave 4 Survey of Teen Activities and Attitudes (Mathematica Policy Research, 2005), administered to youth 42 to 78 months after enrolling in the Title V, Section 510 Abstinence Education Program study sample. Note: All estimates are based on weighted regression models. partners. Distributions for each of the four sites (not shown) likewise show no statistically significant differences between the program and control groups. Programs did not affect the age at which sexually active youth first engaged in sexual intercourse (data not shown). Based on a question asking sexually active youth the age at which they first had sex, the reported mean age at first intercourse is identical between the program and control groups, 14.9 years. This estimate is nonexperimental because age at first sex was only estimated among youth who had had sex; however, results for the fiill sample examining the proportion who had sex by a particular age are consistent with the programs having had no impact on age of first sex. Program group youth were no more likely than control group youth to have unprotected sex. Seven percent of all program group youth and 8 percent of all control group youth reported having had sexual intercourse and not using condoms the first time (Table 6). There are similarly no differences when measured over the last 12 months—17 percent of both program and control group youth reported having had sex in the last 12 months and using a condom only sometimes, and 4 percent in both groups reported having had sex in the last 12 months and never using condoms. For all youth, this latter result implies that 47 percent of youth who were sexually active in the past 12 months had unprotected sex. Across the individual programs, estimated impacts on unprotected sex, measured either at first intercourse or in the last 12 months, were likewise small and statistically insignificant. Ten percent of youth in both the program and control groups reported having been pregnant or gotten someone pregnant; roughly half of them (5 percent overall) reported that they had had a baby, and there were no statistically significant differences between the program and control groups on these measures (Table 6). With respect to STDs, only a small fraction of youth in both groups, about 5 percent overall, reported being told by a doctor that they had an STD. (Of course, many youth may be unaware they have an STD.) Across the individual program sites, impacts on these outcomes were not statistically significant. Journal of Policy Analysis and Management DOI: 10.1002/pam Published on behalf of the Association for Public Policy Analysis and Management Impacts of Abstinence Education on Sexually Transmitted Diseases I 269 Table 6. Impacts on unprotected sex and consequences of teen sex, all four programs rnmhinpri Program Control Program-Control Group Group Difference (Percentage) (Percentage) (Percentage Points) p-value Unprotected Sex at First Intercourse Remained abstinent (always) 49 Had sex, used condom first time 44 Had sex, no condom first time 7 F-test of distributional differences Unprotected Sex in the Last 12 Months Abstinent last 12 montbs 56 Had sex, always used condoms 23 Had sex, sometimes used condoms 17 Had sex, never used condoms 4 F-test of distributional differences Consequences of Teen Sex Ever been pregnant 10 Ever had a baby 5 Ever had an STD (reported) 5 49 43 8 0 1 —1 0.91 0.59 0.45 0.40 55 23 17 4 1 —1 0 0 0.76 0.77 0.88 0.84 0.95 10 5 4 1 -1 1 0.68 0.56 0.53 Source: Wave 4 Survey of Teen Activities and Attitudes (Mathematica Policy Research, 2005), administered to youth 42 to 78 months after enrolling in the Title V, Section 510 Abstinence Education Program study sample. Note: All estimates are based on weighted regression models. Program-control difference may not equal difference in percentages due to rounding. F-tests of distributional differences are computed from multinomial logistic regressions of the categorical outcome variable on an indicator for program status and the baseline control variables. Impacts on Knowledge of STDs ond Risks Associated with Teen Sex On the final follow-up survey, youth were given a list of 13 diseases and asked whether or not each was a sexually transmitted disease; of these diseases, nine were actual STDs and four were not STDs. Youth in the program group identified an average of 69 percent of these diseases correctly, as STDs or not, whereas youth in the control group identified an average of 67 percent correctly. Although small, this difference is statistically significant (Table 7). Comparing the four programs on this measure, the impact estimate for My Choice, My Future! drives the pooled result. It raised the rate of STD identification by an estimated eight points, from a mean of 75 percent for the control group to a mean of 83 percent for the program group. Findings remain consistent when examining impacts separately for diseases that are STDs and those that are not. Overall, program group youth correctly identified a higher percentage of diseases of both types, though only the impact on true STDs remained statistically significant (Table 7). This consistency suggests that programs did not simply raise the likelihood that youth believed any disease was transmitted sexually; rather, they had a beneficial long-term impact on STD identification. Many study youth understood the risks of pregnancy and STDs from unprotected sex, but they often lacked an understanding of the potential health risks from STDs. On a two-item scale measuring their understanding of unprotected sex risks, youth in both the program and control groups had high scores (0.88) (Table 7). On a threeitem scale measuring their understanding of potential health risks of STDs, however. Journal of Policy Analysis and Management DOI; 10.1002/pam Published on behalf of the Association for Public Policy Analysis and Management 270 / Impacts of Abstinence Education on Sexually Transmitted Diseases Table 7. Estimated impacts on STD identification, knowledge of pregnancy and STD risks, overall and by site. Program Control Group Group Program-Control (Scale Mean) (Scale Mean) Difference p-value Four Programs Combined Overall identification of STDs Identification of true STDs Identification of false STDs JCnowledge of unprotected sex risks Knowledge of STD consequences 69 75 57 0.88 0.52 67 72 55 0.88 0.51 2 2 2 0.00 0.02 0.00*** 0.01*** 0.10 0.85 0.20 My Choice, My Future! Overall identification of STDs Identification of true STDs Identification of false STDs Knowledge of unprotected sex risks Knowledge of STD consequences 83 85 78 0.98 0.60 75 77 70 0.94 0.55 8 8 8 0.03 0.05 000*** 000*** 0.00** 0.04** 0.05* ReCapturing the Vision Overall identification of STDs Identification of true STDs Identification of false STDs Knowledge of unprotected sex risks ICnowledge of STD consequences 74 79 64 0.92 0.56 72 76 63 0.95 0.56 2 3 1 -0.03 0.00 0.16 0.11 0.70 0.09* 0.90 FUPTP Overall identification of STDs Identification of true STDs Identification of false STDs Knowledge of unprotected sex risks Knowledge of STD consequences 63 70 48 0.88 0.52 65 70 52 0.86 0.47 -1 0 -4 0.02 0.05 0.45 0.90 0.22 0.47 0.08* Teens in Control Overall identification of STDs Identification of true STDs Identification of false STDs Knowledge of unprotected sex risks Knowledge of STD consequences 57 64 39 0.74 0.40 56 65 36 0.75 0.44 1 0 4 -0.01 -0.04 0.55 0.85 0.11 0.64 0.07* Source: Wave 4 Survey of Teen Activities and Attitudes (Mathematica Policy Research, 2005), administered to youth 42 to 78 months after enrolling in the Title V, Section 510 Abstinence Education Program study sample. Note: All estimates are based on weighted regression models. Program-control difference may not equal difference in means due to rounding. ***p-value (of program-control difference) < 0.01; **p-value < 0.05; *p-value < 0.10, two-tailed test. the mean values on this scale were relatively low (0.52 and 0.51 for prograrn and control youth, respectively) and corresponded to a typical youth answering only about half the items of the scale correctly. Overall, there were no statistically significant impacts on these scales. Despite the overall lack of impacts on these scales, one of the programs. My Choice, My Future! shows consistent evidence of improving youth knowledge of the risks of unprotected sex and STDs. On both scales shown in Table 7, the mean among program group youth in My Choice, My Future! was significantly higher than among their control group counterparts, reflecting a gain in knowledge attributable to the Journal of Policy Analysis and Management DOI: 10.1002/pam Published on behalf of the Association for Public Policy Analysis and Management Impacts of Abstinence Education on Sexually Transmitted Diseases I 271 program. Other programs also displayed some statistically significant differences between program and control group youth on the two scales, but these differences are less consistent. Impacts on Perceptions of Pregnoncy and STD Prevention Perceived Effectiveness of Condoms Program and control group youth had similar perceptions about the effectiveness of condoms for pregnancy prevention (Table 8). About half of the youth in both groups reported that condoms usually prevent pregnancy, and 38 percent reported that condoms sometimes prevent pregnancy. Only 3 percent of youth reported that condoms never prevent pregnancy, whereas 7 percent reported being unsure. With respect to STD prevention, a substantial proportion of youth in both the program and control groups reported being unsure about the effectiveness of condoms at preventing STDs. For example, roughly one-quarter of youth in both groups reported being unsure about whether condoms are effective at preventing chlamydia and gonorrhea or at preventing herpes and HPV. In addition, a sizeable fraction in both groups, about one in seven, reported being unsure about condoms' Table 8. Estimated impacts on perceived effectiveness of condoms for preventing pregnancy and STDs. Control Group (Percentage) Program-Control Difference (Percentage Points) Condoms Prevent Pregnancy Usually 51 Sometimes 38 Never 3 Unsure 7 52 38 3 7 -1 0 1 0 0.63 0.88 0.49 0.83 Condoms Prevent HFV Usually 34 Sometimes 30 Never 21 Unsure 14 38 30 17 15 -4 0 5 -1 0.07* 0.97 0.01** 0.76 Condoms Prevent Chlamydia and Gonorrhea Usually 30 35 Sometimes 27 25 Never 20 14 Unsure 23 26 -5 2 6 -3 0.03** 0.37 0.00*** 0.15 Condoms Prevent Herpes and HPV Usually 26 Sometimes 26 Never 23 Unsure 25 -5 1 7 -3 0.03** 0.77 0.00*** 0.10* Program Group (Percentage) 31 26 15 28 p-value Source: Wave 4 Survey of Teen Activities and Attitudes (Mathematica Policy Research, 2005), administered to youth 42 to 78 months after enrolling in the Title V, Section 510 Abstinence Education Program study sample. Notes: Program-control difference may not equal difference in percentages due to rounding. ***p-value (of program-control difference) < 0.01; **p-value < 0.05; *p-value < 0.10, two-tailed test. Joumal of Policy Analysis and Management DOI: 10.1002/pam Published on behalf of the Association for Public Policy Analysis and Management 272 / Impacts of Abstinence Education on Sexually Transmitted Diseases effectiveness for preventing HIV. These findings contrast with those for pregnancy prevention, for which very few youth in either group reported being unsure about condoms' effectiveness. Program group youth were less likely than control group youth to report that condoms are usually effective at preventing STDs, and they were more likely to report that condoms are never effective at preventing STDs. For example, 21 percent of program group youth reported that condoms never prevent HIV, compared to 17 percent of control group youth. For herpes and HPV, 23 percent of program group youth reported that condoms are never effective, compared to 15 percent of control group youth. The differences in the perceived effectiveness of condoms in preventing STDs are largely the result of one program—My Choice, My Future! As discussed earlier, in this program site, program and control group youth differed significantly in the health and sex education services received by youth. Moreover, this abstinence education program had a strong emphasis on STD knowledge; the tenth-grade program featured slide-show materials from the Medical Institute of Sexual Health, which provided detailed information on STDs and instructed students that abstinence is the only certain way to avoid contracting them. Perceived Effectiveness of Dirth Control Piils Just over 55 percent of the youth in both the program and control groups reported that, when used properly, birth control pills usually prevent pregnancy (Table 9). With respect to STD prevention, more than two out of three youth reported, correctly, that birth control pills do not prevent STDs. And for each type of STD investigated, a significantly higher proportion of youth in the program group than in the control group reported this was the case. For example, 73 percent of program group youth correctly reported that birth control pills never prevent HIV compared to 69 percent of control group youth, a statistically significant difference of four points. DISCUSSION The evaluation of abstinence education programs has been conducted over a period of nine years. It started just after the funding authorization in 1998 and focused on the "first generation" of the A-H abstinence education programs. The evaluation has included both implementation and impact analyses, with multiple site visits to observe the programs and longitudinal follow-up of study youth over a period of four to six years. Several prior DHHS study reports document the implementation experiences of the schools and communities operating the programs and first-year impacts of the programs on potential mediating outcomes (Devaney, Johnson, Maynard, & Trenholm, 2002; Maynard et al., 2005). These studies, together with this final impact analysis study, highlight several important considerations for addressing persistent concerns associated with teen sexual activity. The abstinence education models tested in these four programs did not reduce teen sexual activity. Findings from this study contribute to the policy debate on whether abstinence education is effective at reducing teen sexual activity and its negative consequences, as well as whether abstinence education puts teens at increased risk of pregnancy and STDs. The impact results from four selected programs show no impacts on rates of sexual abstinence. About half of all study youth had remained abstinent at the time of the final follow-up survey, and program and control group youth had similar rates of sexual abstinence. Moreover, the average age at first sexual intercourse and the number of sexual partners were almost identical for program and control youth. Journal of Policy Analysis and Management DOI: 10.1002/pam Published on behalf of the Association for Public Policy Analysis and Management Impacts of Abstinence Education on Sexually Transmitted Diseases I 273 Table 9. Estimated impacts on perceived effectiveness of birth control pills for preventing pregnancy and STDS. Program Group (Percentage) Control Group (Percentage) Program-Control Difference (Percentage Points) p-value Birth Control Pills Prevent Pregnancy Usually 56 33 Sometimes 3 Never 7 Unsure 55 36 3 7 1 _2 0 1 0.55 0.32 0.62 0.65 Birth Control Pills Prevent HIV Usually 6 6 Sometimes 73 Never 16 Unsure 6 7 69 18 0 _2 4 -2 0.94 0.15 0.04** 0.15 Birth Control Pills Prevent Chlamydia and Gonorrhea 4 Usually 6 Sometimes 71 Never 19 Unsure 5 5 67 23 -1 0 4 -3 0.15 0.71 0.03** 0.06* Birth Control Pills Prevent Herpes and HPV 4 Usually 4 Sometimes 71 Never 21 Unsure 5 6 67 22 -1 -2 3 -1 0.54 0.08* 0.09* 0.64 Source: Wave 4 Survey of Teen Activities and Attitudes (Mathematica Policy Research, 2005), administered to youth 42 to 78 months after enrolhng in the Title V, Section 510 Abstinence Education Program study sample. Note: Program-control difference may not equal difference in percentages due to rounding. ***p-value (of program-control difference) < 0.01; **p-value < 0.05; *p-value < 0.10, two-tailed test. Contrary to potential concerns raised by some policymakers, researchers, and health educators, the selected abstinence education programs did not increase the risks of teen pregnancy and STDs. Some have questioned the A-H abstinence education programs, believing that the focus on abstinence may put teens at risk of having unprotected sex. The evaluation findings suggest that this is not the case. Program and control group youth showed no difference in their rates of unprotected sex, either at first intercourse or over the last 12 months. Over the last 12 months, for example, 21 percent of both program and control group youth (47 percent of sexually active youth) reported having had sex and not always using a condom. Teens have important gaps in knowledge of STDs. Both program and control group youth appear better informed about the risks of pregnancy than about the risks or consequences of contracting STDs. On a scale measuring STD identification, youth were correct only about two-thirds of the time; and on a scale measuring their understanding of the health consequences of STDs, youth on average got only about half of the answers correct. Moreover, although a high proportion of youth reported that having unprotected sex just once could result in an STD, 47 percent of sexually active youth had unprotected sex in the previous 12 months. Journal of Policy Analysis and Management DOI: 10.1002/pam Published on behalf of the Association for Public Policy Analysis and Management 274 / Impacts of Abstinence Education on Sexually Transmitted Diseases Many abstinence education programs focus on the risks of STDs, and the evaluation results show some improvements in knowledge of STDs. Program group youth correctly identified a significantly higher proportion of STDs than control group youth, and program group youth were significantly more likely than control group youth to report (correctly) that birth control pills are never effective at preventing STDs (including HIV, chlamydia and gonorrhea, and herpes and human papillomavirus [HPV]). For both outcomes. My Choice, My Future! is the main source of the differences seen overall. Program group youth, however, were less likely than control group youth to perceive condoms as effective at preventing STDs. Compared with control group youth, program group youth were less likely to report that condoms are usually effective at preventing HIV, chlamydia and gonorrhea, and herpes and HPV. Furthermore, program group youth were more likely than control group youth to report that condoms are never effective at preventing these STDs. As above. My Choice, My Future! is a main source of these overall impacts. Targeting youth at young ages may not be sufficient or effective. As with the four programs in this study, most abstinence education programs have been implemented in upper elementary and middle schools. In addition, most programs are completed before youth enter high school, when rates of sexual activity increase and many teens are either contemplating or having sex. Findings from this study provide no evidence that abstinence programs implemented in upper elementary and middle schools are effective at reducing the rate of teen sexual activity several years later. However, the findings provide no information on the effects programs might have had if they were implemented for high school youth or began at earlier ages but served youth through high school. In addition, at the time when most abstinence education programs are completed and youth enter their adolescent years, support for abstinence among their friends falls dramatically. For example, survey data from the start of the impact study show that nearly all youth had friends who exhibited attitudes and behaviors supportive of abstinence. Four years later, however, the typical youth in the study reported that only two of his or her five closest friends remained supportive of abstinence. Looking Ahead This study examined only four programs, which began serving study youth in either upper elementary or middle schools within a few years after the start of the Title V, Section 510 abstinence education funding in 1998. The programs were selected because they held promise; they appeared well implemented and replicable, had curricula consistent with the A-H program guidelines, and were relatively intense. Nevertheless, the findings for these programs may not reflect the experiences of abstinence programs more broadly, particularly those that have been developed more recently or that serve older teens in high school settings. Overall, this evaluation highlights the challenges faced by programs aiming to reduce adolescent sexual activity. Nationally, about half of all high school youth report having had sex, and more than one in five students report having had four or more sexual partners by the time they complete high school. One-quarter of sexually active adolescents nationwide have an STD, and many STDs are lifelong viral infections with no cure. Findings from this study speak to the continued need for rigorous research on how to combat the high rate of teen sexual activity and its negative consequences. Journal of Policy Analysis and Management DOI: 10,1002/pam Published on behalf of the Association for Public Policy Analysis and Management Impacts of Abstinence Education on Sexually Transmitted Diseases I 275 CHRISTOPHER TRENHOLM is Associate Director of Research at Mathematica Policy Research. BARBARA DEVANEY is Senior Vice President and Managing Director at Mathematica Policy Research. KENNETH FORTSON is a Researcher at Mathematica Policy Research. MELISSA CLARK is a Senior Researcher at Mathematica Policy Research. LISA QUAY BRIDGESPAN is an Associate Consultant for the Bridgespan Group in San Francisco, CA. JUSTIN WHEELER is Director of High School Placement at the KIPP Philadelphia Charter School. ACKNOWLEDGMENTS We would like to thank Rebecca Maynard, former Project Director and Co-Principal Investigator, whose hard work, creative thinking, and unwavering commitment to rigorous evaluation design made this study possible. We also thank the abstinence education grantees who agreed to participate in this evaluation, two anonymous referees, and the following individuals who provided valuable guidance, comments, and support throughout the study—Meredith Kelsey, Amy Johnson, members of the Abstinence Technical Work Group, Martha Moorehouse, Barbara Broman, Lisa Trivits, Nicole Gardner-Neblett, Peter Schochet, Alan Hershey, and William Garrett. This study was funded by the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, contract no, HHS 100-98-0010, The opinions and conclusions expressed in this paper are those of the authors and do not necessarily represent the views of the U.S. Department of Health and Human Services or others. REFERENCES Bamett, J. E., & Hurst, C, S, (2003), Abstinence education for rural youth: An evaluation of the Life's Walk program. Journal of School Health, 73, 264-268, Bloom, H. (1984), Accounting for no-shows in experimental design. Evaluation Review, 8, 225-246, Borawski, E, Lovegreen, L,, Demko, C, Guwatudde, D,, Abbott, K., & Stewari;, S. (2001). Evaluation of the teen pregnancy prevention programs funded through the wellness block grant (1999-2000). Cleveland, OH: Center for Health Promotion and Research, Department of Epidemiology and Biostatistics, Case Western Reserve University, Denny, G,, & Young, M, (2006). An evaluation of an abstinence-only sex education curriculum: An 18-month follow-up. Joumal of School Health, 76, 414-422. Devaney, B., Johnson, A., Maynard, R. A., & Trenholm, C. (2002). The evaluation of abstinence education programs funded under Title V, Section 510: Interim report. Washington, DC: U.S. Department of Health and Human Services. DiEiore, K,, Mays, V., & Ross, S. (2007). The effects of an interactive, computer-based, abstinence education curriculum on selected student outcomes, Califomian Joumal of Health Promotion, 5, 55-61, Doniger, A, S., Riley, J. S., Utter, C. A,, & Adams, E. (2001), Impact evaluation of the "Not Me, Not Now" abstinence-oriented, adolescent pregnancy prevention communications program, Monroe County, NY, Joumal of Health Communication, 6, 45-60. Joumal of Policy Analysis and Management DOI: 10,1002/pam Published on behalf of the Association for Public Policy Analysis and Management 276 / Impacts of Abstinence Education on Sexually Transmitted Diseases Edwards, D,, Bellar, S., Scearce, L., & Cathell, A. (2007). Evaluation of WhykNOw Abstinence core curriculum and Road to Excellence programs. Presentation at the 2007 Abstinence Education Evaluation Conference: Strengthening Programs Through Scientific Evaluation, Baltimore, MD. Retrieved September 30, 2007, from http://www ent-s-t com/ ESTOPA/ slides.htm. Halpin, G,, & Halpin, G, (2007), Abstinence education: Program evaluation with youth survey Presentation at the 2007 Abstinence Education Evaluation Conference: Strengthening Programs Through Scientific Evaluation, Baltimore, MD. Retrieved September 30, 2007, from http://www.ent-s-t.com/ESTOPA/slides.htm, Kirby, D, (2002), Do abstinence-only education programs delay the initiation of sex among young people and reduce teen pregnancy? Washington, DC: National Campaign to Prevent Teen Pregnancy, Lemer, R, (2004). Can abstinence work? An analysis ofthe Best Friends Program. Adolescent and Family Health, 3, 185-192. Mathematica Policy Research, (1999). Wave 1 survey of teen activities and attitudes. Princeton, NJ: Author. Mathematica Policy Research (2005). Wave 4 survey of teen activities and attitudes. Princeton, NJ: Author, Maynard, R, A,, Trenholm, C, Devaney B,, Johnson, A,, Clark, M. A,, Homrighausen, J., & Kalay, E, (2005). First-year impacts of four Title V, Section 510 abstinence-education programs. Washington, DC: U.S. Department of Health and Human Services, Pickert, S,, Theis, L,, Wetta-Hall, R,, & Crowe, R. E. (2007). Abstinence education works: Evaluation of the Pure & Simple Lifestyle project. Presentation at the 2007 Abstinence Education Evaluation Conference: Strengthening Programs Through Scientific Evaluation, Baltimore, MD, Retrieved September 30, 2007, from http://www,ent-s-t.com/ESTOPA/ slides.htm, Sather, L,, & Zinn, K. (2002), Effects of abstinence-only education on adolescent attitudes and values conceming premarital sexual intercourse. Family & Community Health, 25, Scher, L. S., Maynard, R. A., & Stagner, M. (2006), Interventions intended to reduce pregnancyrelated outcomes among teens. Retrieved September 30, 2007, from http://www,campbell coUaboration.org/doc-pdf/teenpregreview dec2006.pdf. Seufert, R, L., Carrozza, M. A., Kubilius, K. A., & Huber, V. (2007). Abstinence education program evaluation: structural equation modeling and social theory. Presentation at the 2007 Abstinence Education Evaluation Conference: Strengthening Programs Through Scientific Evaluation, Baltimore, MD, Retrieved September 30, 2007, from http://www.ent-s-t,com/ ESTOPA/slides,htm. Weed, S, E. (2001), Title V education programs: Phase I interim evaluation report to Arkansas Department of Health. Salt Lake City UT: Institute for Research and Evaluation. Weed, S. E., Olsen, J. A., DeGaston, J,, & Prigmore, J. (1992). Predicting and changing teen sexual activity rates: A comparison of three Title XX programs. Washington, DC: Office of Adolescent Pregnancy Programs. Young, M., & Denny, G. (2007), An evaluation of an abstinence-only sex education curriculum; an 18-month follow-up. Presentation at the 2007 Abstinence Education Evaluation Conference: Strengthening Programs Through Scientific Evaluation, Baltimore, MD. Retrieved September 30, 2007, from http://www,ent-s-t,com/ESTOPA/slides,htm. Joumal of Policy Analysis and Management DOI: 10,1002/pam Published on behalf of the Association for Public Policy Analysis and Management
Purchase answer to see full attachment
User generated content is uploaded by users for the purposes of learning and should be used following Studypool's honor code & terms of service.

Explanation & Answer

Attached.

Running head: ADOLESCENT THERAPY

1

Adolescent Therapy
Student’s Name
Course
Institution
Date

ADOLESCENT THERAPY

2
Introduction

Teenage or adolescence is a transitional stage in a human's physical and psychological
development that takes place during the period from puberty to the legal adulthood.
Individuals undergoing this transition are known as teenagers or adolescents and are usually
aged between 13 and 19 years old. According to Albert, Chein and Steinberg (2013), teenage
is usually the age of experimentation with a lot of things in life including cigarette smoking,
drinking, and sex. It is therefore important that individuals at this stage of life are given the
attention and space they require in equal measure. Additionally, this stage requires the
provision of enough information to aid in decision making with regards to the teenager's sex
life as well as other aspects of their social life. This paper presents ways in which teenagers
can be provided with healthy sex talks that will ensure that they make informed decisions
regarding their sex life.
Ways in Which a Teens' Increased Reward Drive is manifested
Teenagers' minds are frequently depicted as tizzies of hormones and impulse even
though the decisions that they make are often extremely reasonable and worthy of more
consideration. There are three important ways in which the brain's increased desire for reward
in teenage is exhibited in their lives including impulsiveness, susceptibility to addiction and
hyper-rationality (Siegel, 2015). Each of these manifestations may be expressed by the
teenager in unhealthy ways, but there are systemic interventions that can be done to address
the behavior.
Impulsiveness refers to situations in which behavior occurs without the teen's
thoughtful reflection. The teen is unable to pause and think past the immediate dopamine-led
impulse pulsating on their mind. This can be expressed in several unhealthy ways that may be
present in therapy including impatience, compulsive sexual behavior, physical and emotional

ADOLESCENT THERAPY

3

outbursts and the uncontrollable and irresistible urge to hoard items that do not belong to
them (Romer, 2010). Impulsiveness may get the teenager engaging in risky behavior without
thinking through the repercussions. Sometimes the teen may blame themselves, situations or
the people around them for their impulsiveness and it is therefore important that the therapist
recognizes the behavior for ease of counseling.
During therapy, the teenager's susceptibility to addiction can be expressed several
ways. The most pronounced form of their expression of susceptibility to addiction is drug and
substance addiction or other forms of addic...


Anonymous
Just the thing I needed, saved me a lot of time.

Studypool
4.7
Trustpilot
4.5
Sitejabber
4.4

Similar Content

Related Tags